Provider Demographics
NPI:1699846378
Name:JAMES, BETHANY A (OD)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:A
Last Name:JAMES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 ALLEGHENY RIVER BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1735
Mailing Address - Country:US
Mailing Address - Phone:412-828-5333
Mailing Address - Fax:
Practice Address - Street 1:416 ALLEGHENY RIVER BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-1735
Practice Address - Country:US
Practice Address - Phone:412-828-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001210152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1863911Medicaid
PA5798920001Medicare NSC
PAU87789Medicare UPIN
PA1863911Medicaid